| NPI | 1750606679 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q5592) | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX Q5592) | 
| Enumeration Date | 2010-04-03 | 
| Last Update Date | 2024-05-21 |